scholarly journals A simple novel technique [PUIT] for closure of urethrocutaneous fistula after hypospadias repair: Preliminary results

2005 ◽  
Vol 38 (02) ◽  
pp. 114-118
Author(s):  
M S Awad
Keyword(s):  
Common Complication ◽  
Hypospadias Repair ◽  
Fistula Repair ◽  
Urethrocutaneous Fistula ◽  
Good Opportunity ◽  
Good Cosmetic Outcome ◽  
Novel Technique ◽  
Good Cosmetic ◽  
The Mean ◽  
Incision Technique

ABSTRACTUrethrocutaneous fistula is a common complication of urethroplasty for severe hypospadias, even when a microsurgical technique is applied, the closure of the fistula is a challenging problem. We present a simple surgical procedure, posterior urethral incision technique [PUIT] to close the fistula in our department.Between February 2001 and December 2004 we prospectively evaluated 32 patients, 26 patients with initial hypospadias fistulas and 6 with recurrent fistulas who underwent closure of urethrocutaneous fistula after hypospadias repair. The mean age of patients was 5 years, the operation consisted of trimming the fistula edge after mobilization of the skin all-around then a midline posterior urethral incision was done 2 mm above and 2 mm below the fistula opening then re-approximation of the urethral edges using 6/0 vicryl sutures with loop magnification.The timing of fistula repair was between 6 and 13 months after it was formed, all of these were effectively closed except three cases with stricture and fistula. Of these, two were completely relieved after repeated urethral dilatation, three times a week for 2 weeks. The third failed case will need another sitting after 6 months.The posterior midline urethral incision gives a good opportunity for repair without tension with a good cosmetic outcome. This may be done under local anesthesia in adults. The procedure is considered simple rapid and easy to be done for variable fistulas types whatever of its site and the age.

How We Do Buried Penis Reconstruction in Children: A Novel Technique

2018 ◽  
Vol 24 (8) ◽  
pp. 6164-6167
Author(s):  
Widi Atmoko ◽  
Gerhard Renaldi Situmorang ◽  
Irfan Wahyudi ◽  
Arry Rodjani
Keyword(s):  
Complete Separation ◽  
Voiding Function ◽  
Novel Technique ◽  
Good Cosmetic ◽  
Asking Questions ◽  
The Mean ◽  
Time Of Operation ◽  
Satisfaction Rates ◽  
Buried Penis

Buried penis is a pathology for which several reconstructive techniques are described. We described a novel technique involving complete separation of dartos fascia from the skin and penis and excision of dartos fascia until penile fixation to pubic region after complete degloving of penis to eradicate the abnormal attachments of the dartos muscle to the corporal bodies and evaluated the efficacy and safety of our technique. From June 2009 and February 2015, 28 patients underwent surgical repair of buried penis with our novel technique. We administered a questionnaire asking questions about penile size, morphology, and voiding status to evaluate parental satisfaction. The mean age of patients at the time of operation was 9.50±2.09 years, and the mean duration of follow-up was 23.27±16.75 months. The mean satisfaction grades for penile size, morphology, and voiding function were improve (p < 0.05) (Fig. 2). The mean preoperative satisfaction grade concerning penile size was 0.82±0.76, and it improved postoperatively to 2.67±0.52 at the last follow-up (p < 0.001). The mean preoperative satisfaction grade for penile morphology was 0.86 ± 0.55, which improved to 2.12±0.40 at the last follow-up visit (p < 0.001). The mean preoperative satisfaction grade for voiding function was 1.10±0.72, which improved to 2.94±0.86 at the last follow-up visit (p < 0.001). There were no complications such as postoperative infection and tissue necrosis. Edema developed in 2 patients, but resolved spontaneously after 1 month. Our method of buried penis correction was found to be technically feasible and safe. It results in a good cosmetic appearance and excellent postoperative satisfaction rates in terms of size, morphology, and voiding function. Further research is needed to understand its pathophysiology.

scholarly journals Dorsal vertical island flap urethroplasty in children with hypospadias: a single center’s experience 75 patients

2019 ◽  
Vol 2 (1) ◽  
pp. e000021
Author(s):  
Gontumukkala Chalapathi ◽  
Kadiri Sitha Ramaiah ◽  
Javvadi Veeraswamy
Keyword(s):  
Good Alternative ◽  
Urethral Diverticulum ◽  
Vertical Tube ◽  
Island Flap ◽  
Urethrocutaneous Fistula ◽  
Urethral Plate ◽  
Meatal Stenosis ◽  
Cosmetic Appearance ◽  
Good Cosmetic ◽  
The Mean

ObjectiveTo assess the results and complications of dorsal vertical island flap (DVIF) urethroplasty.MethodsA total of 175 children were operated on for hypospadias. Out of these, 41 with proximal hypospadias with severe chordee required two-stage urethroplasty. In 18 babies with glanular hypospadias, a meatal advancement and glanuloplasty procedure was done. In 25 babies with mid-penile and distal penile hypospadias, tubularized incised urethral plate (TIP) urethroplasty was the option. 16 babies with unhealthy urethral plate and chordee were chosen for dorsal vertical tube urethroplasty after excision of the urethral plate. The rest of the 75 babies with proximal, mid-penile or distal penile hypospadias with no or minimal chordee after degloving and poor urethral plate were chosen for DVIF urethroplasty. These 75 babies with DVIF were followed up from 3 months to 5 years to assess complications such as urethrocutaneous fistula, meatal stenosis, glans dehiscence, megalourethra or urethral diverticulum, stricture, and penile torsion/rotation.ResultsA total of 75 patients with proximal, mid-penile, or distal penile hypospadias in whom DVIF was used during the study period were included. The mean age was 3.7 years, ranging from 8 months to 14 years. Fourteen patients developed complications (18.6%). The most common complication was urethrocutaneous fistula, which was seen in seven (9.3%) patients. Glans dehiscence was seen in five patients (6.6%), and one had meatal stenosis with diverticulum formation. Skin necrosis was observed in one patient. In 61 patients, stream was good, with no torsion, and good cosmetic appearance was observed.ConclusionsDVIF is a good alternative to TIP in mid-penile and distal penile hypospadias. Our early experience with DVIF urethroplasty showed an acceptable rate of complications and good cosmetic results.

scholarly journals Congenital urethrocutaneous fistula in an adolescent male

2015 ◽  
Vol 48 (02) ◽  
pp. 204-207
Author(s):  
Satish M. Kale ◽  
Nikunj B. Mody ◽  
Surendra B. Patil ◽  
Pranam Sadawarte
Keyword(s):  
Adolescent Male ◽  
Common Complication ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Rare Anomaly ◽  
Congenital Fistula

ABSTRACTA urethrocutaneous fistula is a common complication after hypospadias repair, but congenital fistula is a rare anomaly. We present a 16-year-old boy with this unusual anomaly. Its etiology, embryology, and management are discussed in brief.

scholarly journals Degloving injury of the distal aspect of the limb in a horse and preventing bone sequestrum formation using multiple, partial depth cortical fenestration

2021 ◽  
Vol 90 (1) ◽  
pp. 57-61
Author(s):  
Filip Koľvek ◽  
Zdeněk Žert
Keyword(s):  
Granulation Tissue ◽  
Clinical Report ◽  
Common Complication ◽  
Outer Cortex ◽  
Good Cosmetic Outcome ◽  
Degloving Injury ◽  
Exposed Bone ◽  
Good Cosmetic ◽  
Distal Aspect ◽  
The Right

Exposed or denuded bone is a common complication of wounds of the distal aspect of the limb. This clinical report describes the treatment of an extensive laceration of the right hindlimb of a 12-year-old Hungarian Warmblood Horse gelding, which was managed initially by application of hydrogel dressings to enhance autolytic debridement, subsequently, by cortical fenestration of the denuded cortical bone and by stimulating the production of granulation tissue to cover the exposed bone. An early radiographic sign of sequestrum formation (discrete changes in the outer cortex) was not seen after the injury. Six weeks later, the wound was completely covered with vascularized, healthy-appearing bed of granulation tissue, which was prepared for grafting using the punch technique. A reinforced bandage was applied for the following 7 weeks; the grafts were accepted by granulation tissue. The horse was discharged 20 weeks after admission and the owners were advised to maintain stall rest with hand walking for two weeks. Four years later the owner reported that the wound had completely healed with a good cosmetic outcome and the horse was being used in a carriage.

scholarly journals Endoscopic Stricturotomy Is an Efficacious Option for Management of Strictures in Patients With Inflammatory Bowel Disease

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Nabeeha Mohy-ud-din ◽  
Gursimran S Kochhar
Keyword(s):  
Inflammatory Bowel Disease ◽  
Success Rate ◽  
Bowel Disease ◽  
Chart Review ◽  
Common Complication ◽  
Technical Success ◽  
Technical Success Rate ◽  
Safe Technique ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Strictures are a common complication for patients with inflammatory bowel disease. Endoscopic stricturotomy (ESt) is a novel procedure for treatment of these strictures. Methods A chart review was performed for patients with strictures who underwent ESt. Results Eleven patients were included in the study and the total number of strictures treated was 12. The mean length of the strictures was 10.25 ± 4.36 mm. Technical success was achieved in 92% (n = 11) of the procedures. Postprocedural bleeding occurred in 9% (n = 1) of patients, and none of the patients had complications of infection or perforation. Conclusions ESt is a safe technique with high technical success rate.

An Experimental Investigation of Flow-Induced Cavity Resonance

2001 ◽  
Author(s):  
Paul J. Zoccola ◽  
Theodore M. Farabee
Keyword(s):  
Experimental Investigation ◽  
Energy Production ◽  
Pressure Fluctuations ◽  
Cavity Resonance ◽  
Cavity Pressure ◽  
Novel Technique ◽  
Cavity Opening ◽  
The Mean ◽  
Marine Applications ◽  
Opening Phase

Abstract Excitation of cavity resonance by flow over an aperture is often a source of unwanted noise in aerospace, automotive, and marine applications. An experimental investigation of this phenomenon was conducted. Detailed measurements of the cavity pressure and the velocity field in the opening were performed in a quiet flow facility. Spectral data on cavity pressure fluctuations obtained for a variety of configurations were analyzed over a range of speeds to determine the behavior of both sheartones and cavity tones during non-resonant and resonant conditions. The mean and fluctuating velocity profiles as well as the cross-spectral properties between the velocity components and cavity pressure were also obtained within the cavity opening. Phase between the velocity components and the pressure was used to calculate the streamwise convection velocities across the opening. A novel technique used to measure vorticity allowed calculation of the measured energy production in the opening. The data support the finding that the resonant and non-resonant conditions are distinguished by the behavior of the convection velocity and by the distribution of energy production in the flow field.

Midshaft Hypospadias: Review of Surgical Technique

2019 ◽  
Author(s):  
Erin R. McNamara ◽  
Bryan Sack ◽  
Alan B. Retik
Keyword(s):  
Surgical Technique ◽  
Key Words ◽  
Common Type ◽  
Hypospadias Repair ◽  
Urethrocutaneous Fistula ◽  
Tubularized Incised Plate ◽  
Dartos Flap ◽  
Tubularized Incised Plate Urethroplasty ◽  
Skin Coverage

Surgical technique for midshaft hypospadias has evolved since the time of Horton and Devine. The most common type of repair that is currently used is the tubularized incised plate urethroplasty, which is a modification of the Thiersch-Duplay hypospadias repair. The authors review the steps of this procedure in detail and discuss troubleshooting for issues that may arise during the repair. Alternatives for chordee correction and skin coverage are reviewed. The authors briefly discuss outcomes and possible complications. In addition, there is a step-by-step video of a midshaft hypospadias repair that highlights the surgical technique. This review contains 9 figures, and 23 references. Key Words: chordee, dartos flap, hypospadias, midshaft hypospadias, surgical technique, tubularized incised plate (TIP), urethrocutaneous fistula, ventral curvature

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